Sponsored by The University of New Mexico School of Medicine, The Division of Pulmonary, Critical Care and Sleep Medicine University of New Mexico Domenici Center, West Building, 1001 Stanford, NE. This course is designed for occupational health nurses, physicians, health technicians, respiratory therapists and other healthcare personnel involved in the performance and interpretation of pulmonary function testing.

Overview of spirometry equipment, quality control and calibration

ATS standards for acceptable and repeatable result

Effective coaching for best results

Interpreting Flow-volume loops

Hands-on learning

Accreditation: This course has been approved by NIOSH (course #066) and approved for 8 Contact hours approved by NM Respiratory Care Board. Contact: Kyla LeSuer at krlesuer@salud.unm.edu or 505-272-1501 for registration information.

This current report is spotlighting the Respiratory Department of Memorial Medical Center in Las Cruces, New Mexico located at 2450 South Telshor Boulevard. Memorial Medical Center (MMC) is licensed as a 298 bed hospital with a 40 bed ICU/CCU. It has been serving Las Cruces and the surrounding area for over 60 years. MMC has been the recipient of the “Best Hospital” Reader’s Choice Award from 2003 – 2013. MMC is certified by the centers for Medicare and Medicaid (CMS) and is accredited by the Joint Commission. MMC’s vision statement is: To be the hospital where patients choose to come for care, physicians want to practice and team members want to work. MMC’s mission statement is: To care for the community with compassion and respect.

The respiratory department at MMC has twenty full-time and six PRN respiratory therapists. The staff provides outpatient care Monday through Friday from 8:00 to 4:30 and 24/7 inpatient care to patients of all ages. Joseph Armijo RRT is the manager and has been a respiratory therapist since 1998. Recently to help encourage the level of proficiency of every therapist the respiratory team leaders developed an advanced level respiratory therapist with an incentive of monetary gain and higher status recognition. Already a requirement status of all supervisors became available for all therapists to presently or futuristically aspire to achieve. To obtain the advanced level standing therapists have to be a registered respiratory therapist, have a minimum of 5 years experience, be capable of performing complete pulmonary function tests, be able to assist physicians with bronchoscopy procedures, be able to independently perform arterial line insertion procedures, be proficient at operating the specialized ventilator and monitoring system during magnetic resonance imaging procedures, demonstrate effective critical care skills to include effective communication with the critical care team, develop or assist in the development , implement and follow up on performance improvement projects for the respiratory program, participate at least annually in the education of other MMC team members and participate in a MMC committee for a minimum of 3 months a year.

The MMC respiratory department provides care and life support to patients in the emergency room, intensive care units, general hospital areas, the pulmonary diagnostics laboratory and the bronchoscopy suite and has plans to provide care in other specialty areas such as rehabilitation.

The MMC team has delivered more babies than any other hospital in Southern New Mexico. The ability of the staff to care for premature infants and newborns with complications has increased exponentially in the past few years. MMC currently has a level II Neonatal Intensive Care Unit (NICU). MMC is presently in progress of developing a level III NICU as it has the commitment of twenty-four hour neonatologist care. Since this level of NICU necessitates the ability of providing mechanical ventilation and other intensive respiratory therapy, the respiratory therapy staff has been an integral component of the planning. To meet the demand needs of the level II and now level III NICU, all employed respiratory therapists are required to have their certification as neonatal resuscitation providers. To further the ability of the department and staff to serve a level III NICU, they have increased the quantity of neonatal intensive care equipment capabilities. This effort includes the increase in mechanical ventilation capability to include six Drager Baby Log ventilators, two 3100A HFOVs, one Drager TI 500 Globe-Trotter Neonatal Transport System and twenty Vapotherm high flow cannula systems. Aiding this transition of the NICU further (as well as all patient care) is the addition of four new ABL90 FLEX blood gas analyzers allowing the analysis of 17 parameters from blood samples as small as 65 μL in just 35 seconds. Also, in an effort to better serve the neonatal populations of Southern New Mexico, there are plans to create a ground transport team consisting of a paramedic, registered nurse and respiratory therapist.

To learn more about the Respiratory Therapy team at MMC, visit the link below:

http://www.nmsrc.org/2014/06/southwest-regional-hospital-spotlight-report-2nd-ed/feed/0Dan C. Trigg Memorial Hospital – Respiratory Therapisthttp://www.nmsrc.org/2013/12/dan-c-trigg-memorial-hospital-respiratory-therapist/
http://www.nmsrc.org/2013/12/dan-c-trigg-memorial-hospital-respiratory-therapist/#commentsTue, 10 Dec 2013 18:08:09 +0000http://www.nmsrc.org/?p=1014EDUCATION: Graduate from a State Accredited School of Respiratory Care preferred with current State license in Respiratory Care with current Registration.

SKILLS/ABILITIES:
Knowledge of education responsibilities to patients; a well-integrated personality; an understanding and appreciation of good physical and mental health. Knowledge of the communication skills, interest in continued professional growth, knowledge of new trends in rehabilitation and pulmonary treatments and ability to adapt to progressive change.

PRIOR EXPERIENCE:
Minimum of two years experience in the field of pulmonary and/or rehabilitation preferred. Marketing experience strongly preferred.

(This article is the first of a series of articles highlighting respiratory therapists and facilities in the southwest region of New Mexico)

Written by: Blu K. Warren SW Region Director NMSRC

This month’s featured respiratory programs and therapists are from two departments located in Las Cruces, New Mexico, one at Rehabilitation Hospital of Southern New Mexico (RHSNM) and the other at Advanced Care Hospital of Southern New Mexico (ACHSNM). They are owned and operated by Ernest Health, Incorporated.

Roy Rivas, Registered Respiratory Therapist (RRT) was the first Respiratory Therapist employed by Ernest Health, Inc. Roy began his career as a Respiratory Therapist at a local Las Cruces acute care hospital in 1996. Roy’s diverse clinical work experience includes: critical care, diagnostics, Hospital Educator, Durable Medical Equipment Manager, and Clinical/Class Instructor for the Dona Ana Branch Community College. In 1994, Roy started his respiratory position with Ernest Health, Inc. at the flagship rehabilitation hospital, RHSNM, as the sole Respiratory Therapist. Roy assisted in developing respiratory therapy driven protocols, respiratory medical documentation, respiratory assessments and pulmonary physician order sets. Roy’s vision was to further expand the responsibilities of all Respiratory Therapists and the department’s role within the facility; such responsibilities are often beyond the realm of common duty expectations of staff therapists. The focus of this ideal was to promote the mission of patient-centered care and team responsibility for care. These additional duties include: answering the phones, responding to call lights, transportation of patients, passing of meal trays and meal assistance, oral care, medical chart reviews, and patient rounding with physicians. Roy further expanded the respiratory therapy department’s role to become an essential part of the inter-disciplinary patient-centered care team that works closely with the nursing department, therapy department including: physical, occupational, and speech language pathologist, as well as physicians in the development and implementation of patient-centered care plans that drive quality care and outcomes. The Respiratory Therapists have become an integral part of the patient care team and are responsible for assisting with all general care as well as the total inter-disciplinary care of the pulmonary patient from the initial intake of the patient through discharge; to include the initial respiratory consult and establishing the patient plan of care.

The Respiratory Therapists and the department expanded as the needs of the patients and hospital became more inter-disciplinarily driven. Currently there are two full-time, one part-time, two PRN Respiratory Therapists at the 40 bed in-patient physical rehabilitation facility, RHSNM. Rosa Duarte, Certified Respiratory Therapist (CRT) is currently the Respiratory Team Lead at RHSNM. She began her respiratory career at a local Las Cruces acute care hospital in 2004.

Roy moved from the respiratory team lead position at RHSNM and transferred over to a new Ernest Health, Inc. facility, Advanced Care Hospital of Southern New Mexico (ACHSNM) which is a Long Term Acute Care Hospital (LTACH). This was one of the first “duplex” models of healthcare in the United States. Two separate hospitals, two distinct levels of care on the same campus. All of the respiratory department’s standards of respiratory practice from RHSNM were incorporated into the ACHSNM respiratory department standard of practice. In addition, a bronchodilator and a ventilator weaning protocol were added as standards of care. In fact, all of the standards of respiratory practice established at the flagship hospital have been incorporated into all of Ernest Health, Inc.’s facilities.

In 2007, Roy Rivas became Director of Clinical services at ACHSNM; which oversees the respiratory, laboratory, radiology departments and contract patient services. In 2009, Roy added quality and risk to his directorship. In 2012 he was promoted to Director of Compliance over the campus (both hospitals).

At the present, Annette Tankesly, RRT is the Director of Clinical Services at ACHSNM. Annette began her respiratory career employed as a student respiratory care giver at a local Las Cruces acute care hospital in 2002. Annette and Roy were a part of an inter-disciplinary program development team that researched and implemented a Sleep/Wake Cycle Program. The Sleep/Wake Cycle Program is designed to provide optimal patient health by coordinating all patient care activities and creating an environment that accommodates the patient’s natural sleeping and waking habits controlled by the body’s circadian rhythm. An increase in ventilator wean rates were noted after the implementing the Sleep/Wake Cycle.

ACHSNM employs six full-time, one part-time and four PRN Respiratory Therapists. ACSHNM is a 20-bed LTACH. One of their specialties is ventilator weaning. ACHSNM has a vent wean program development team and the highlights of the program can be found at: http://achsnm.ernesthealth.com/images/ACHSNM_ventwean_ph2.pdf

In addition to direct patient care, the Respiratory Therapists in both facilities have become essential educators campus wide, which include training hospital staff for mock codes, basic life support training and oxygen safety (ventilator safety for ACHSNM staff). The respiratory staff is also responsible for patient and family training for tracheostomy care and respiratory medication regimen.

Additionally, two Respiratory Therapists currently work in the marketing department as Clinical Liaisons. Clinical Liaisons evaluate patients and facilitate admissions that have been referred by physicians to these two levels of care. In addition, Clinical Liaison’s educate the community and referral sources of both hospital’s programs and services. Lupe Estrada, RRT works full time as a Clinical Liaison. Lupe began her career as Respiratory Therapist at an El Paso acute care hospital in 1995 and also worked in a Las Cruces acute care hospital as well as in the DME arena. Devra Pierce, RRT works as a PRN Clinical Liaison and practicing therapist. Devra has been an RRT since 1996 and began her career as a Respiratory Therapist at an El Paso Acute Care Hospital. Devra was also employed in a sleep lab and was the Assistant Professor of the Dona Ana Community College Respiratory Program. Both Devra and Lupe worked as direct patient respiratory care givers in the Rehabilitation Hospital of Southern New Mexico.

As profiled in this article, there are many open possibilities for Respiratory Therapists, not only in the State of New Mexico but across the country. Respiratory therapy is a valid and thriving field with many opportunities and diverse rolls as evidenced in this article.

Further information about the facilities mentioned in this article can be found at: